A Comprehensive Solution to Reduce Opioid Abuse

Building upon our history of industry-leading bold actions, Express Scripts today announced a new Advanced Opioid ManagementSM solution that will better address our nation’s opioid-addiction epidemic by working comprehensively with patients, prescribers and pharmacies to minimize early exposure while helping prevent progression to overuse and abuse.

In a recent pilot study of just more than 100,000 Express Scripts members new to opioid therapy, we observed a 38% reduction in hospitalizations and 40% reduction in emergency room (ER) visits in the intervention group versus control group during six months of follow up. Half of patients received an educational letter from the Express Scripts Neuroscience Therapeutic Resource Center (TRC) and half no intervention at all. A subset of patients receiving the TRC educational letter who had high-risk patterns of opioid use also received a counseling call from a Neuroscience TRC specialist pharmacist. Among this subset, we observed a 19% decrease in the day’s supply of opioid dispensing during six-months of follow up. Patients got the medicine they need while we helped prevent unnecessary refills that could put patients at risk of significant harm.

Building on the success of the pilot, Express Scripts added novel opioid management features addressing other points on the care continuum, from safe disposal, to tools for physicians at the point of care and safety checks for dispensing pharmacies. This complete solution is expected to significantly reduce unnecessary prescribing, dispensing and use to help avoid unnecessary hospitalization, ER and drug treatment costs, while ensuring access to medication patients need.

By focusing across the entire care continuum – from over-prescribing to over-dispensing, and unsafe overutilization of pain medications – we found we can make a significant and meaningful difference in this national epidemic. Express Scripts is uniquely positioned to engage prescribers, mobilize payers, and protect patients to comprehensively address the issue. Through our data analytics, specialized care model, fraud, waste and abuse management capabilities and our application of behavioral science, we will do more to help stop abuse before it starts.

Express Scripts’ opioid solution is designed to lower risk at each touchpoint of the care continuum – including prescribers, pharmacies and patients – in a way that far exceeds what other PBMs offer today.

Today’s announcement builds on Express Scripts’ record of industry leadership in the fight against opioid abuse, including its Fraud, Waste and Abuse program, and advocacy for pharmacy and physician lock-in and prescription drug monitoring programs (PDMP). New solutions are needed more than ever, given the outsized toll this epidemic is taking on Americans:

Only 3% of opioids are prescribed by pain specialists

Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids